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Virtual Pediatric Hospital: Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology: Case 56

Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology

Case 56

Michael P. D'Alessandro, M.D.,
Steven J. Fishman, M.D.,
Deborah E. Schofield, M.D.

Peer Review Status: Internally Peer Reviewed
Chief Complaint:
Four week old male with vomiting.

Clinical History:
The patient was a 4 week old male, status post primary repair of esophageal atresia with distal tracheoesophageal fistula, who is in the intensive care unit, who had been vomiting up his G-tube feeds for the last 24 hours.

Clinical Physical Exam:
A palpable olive was present in the mid abdomen.

Clinical Labs:
Non-contributory

Clinical Differential Diagnosis:
Pyloric stenosis

Imaging Findings:
An upper GI at 4 weeks of age showed pyloric channel narrowing. An ultrasound examination of the pylorus from later the same day demonstrated marked thickening and elongation of the pylorus.

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Imaging Differential Diagnosis:
Pyloric stenosis

Operative Findings:
Two days later the patient underwent a pyloromyotomy on a hypertrophied and thickened pylorus.

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Pathological Findings:
None

Final Diagnosis:
Hypertrophic Pyloric Stenosis

Follow-up and Prognosis:
The patient had an uncomplicated post-operative course.

Similar Cases:
None

References:

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